Kubonishi I, Ohtsuki Y, Machida K, Agatsuma Y, Tokuoka H, Iwata K, Miyoshi I
Am J Clin Pathol. 1984 Dec;82(6):730-4. doi: 10.1093/ajcp/82.6.730.
An unusual case of granulocytic sarcoma in a 23-year-old man is reported. The patient initially presented with mediastinal tumor and was diagnosed clinically as having thymoma. The patient was treated by radiotherapy and surgical removal of the tumor. Histology of the excised tumor had been nondiagnostic because of extensive fibrous changes. Eight months later, the patient developed pleural effusion on the right, which soon was followed by blood and bone marrow pictures consistent with acute promyelocytic leukemia. In vitro culture of pleural effusion cells unexpectedly gave rise to a continuously growing peroxidase-positive myeloid cell line. Autopsy revealed the recurrent mediastinal tumor to be positive for intracytoplasmic naphthol AS-D chloroacetate esterase and lysozyme activity. From these findings, the patient retrospectively was diagnosed as having mediastinal granulocytic sarcoma, which terminated in pleural effusion and acute promyelocytic leukemia.
报告了一名23岁男性粒细胞肉瘤的罕见病例。患者最初表现为纵隔肿瘤，临床诊断为胸腺瘤。患者接受了放疗和肿瘤手术切除。由于广泛的纤维改变，切除肿瘤的组织学检查未能明确诊断。八个月后，患者右侧出现胸腔积液，随后很快出现与急性早幼粒细胞白血病一致的血液和骨髓图像。胸腔积液细胞的体外培养意外地产生了一个持续生长的过氧化物酶阳性髓系细胞系。尸检显示复发性纵隔肿瘤胞质内萘酚AS-D氯乙酸酯酶和溶菌酶活性呈阳性。根据这些发现，患者被回顾性诊断为纵隔粒细胞肉瘤，最终发展为胸腔积液和急性早幼粒细胞白血病。
